MRI Report

* FINDINGS *
The cerebral hemispheres show evidence of polymicrogyria. Specifically, there is
cortical dysplasia seen in the region around the sylvian fissures bilaterally
which extends more superiorly and posteriorly than normal. Also, the dysplastic
cortex extends centripetally with infolding or buckling of the cortex. The
dysplastic cortex has an irregular bumpy inner and outer cortical surface. This
is particularly prominent in the bilateral opercular regions posteriorly where
there are anomalous of draining veins.

The ventricular system shows dilatation of the lateral ventricles. The third
ventricle, aqueduct and fourth ventricles are normal. Also, there is increase
amount of CSF space surrounding the cerebral hemispheres. There is a suggestion
of some diminution in the amount of white matter; however, this is somewhat
subtle and may only be accentuated by the infolding of the overlying dysplastic
cortical mantle. The posterior fossa shows no significant abnormalities.

The cervical medullary junction and pituitary fossa are normal. The cranium
demonstrates flattening in the right parietal occipital and suboccipital region.
Also, there is suggestion of increased distance in the area of the ethmoids
between the orbits raising the question of hypertelorism.

* IMPRESSION *
Cortical dysplasia most prominent in the posterior aspect of the sylvian
fissures bilaterally.

Enlargement of the supratentorial ventricular system and prominent
subarachnoid space surrounding the cerebral hemispheres.

Terms like sagittal, axial, coronal, refer to the direction of the view
from which the scan is taken. Coronal is like seeing a slice of the brain from
the front, sagittal from the right or left side, etc. T1, T2, etc are ways in
which the image is processed or what data is taken. These different forms have
technical names, but essentially optimize the view. T2, for example, makes white
matter bright and gray matter dark; T1 the opposite (I could have that
backwards!). FSE stands for fast spin echo, another way of taking data.

* FINDINGS *
The cerebral hemispheres show evidence of polymicrogyria. Specifically, there is
cortical dysplasia seen in the region around the sylvian fissures bilaterally
which extends more superiorly and posteriorly than normal. Dysplasia means
abnormal development resulting in abnormal structure; the sylvian fissure
separates the frontal lobe from the temporal lobe. It is the huge infolding that
you see on the right and left sides of the brain, the one that defines the
"thumb" of the brain, which looks a bit like a hand in a boxing glove when seen
from the side. I think they mean the Sylvian fissure extends up (superior) and
back (posterior) further than it should, but they could mean the same for the
area of dysplasia. (Radiologists are never strong in basic grammar!)

Also, the dysplastic cortex extends centripetally with infolding or buckling
of the cortex. Centripetal means toward the midline, toward the center of the
brain.

The dysplastic cortex has an irregular bumpy inner and outer cortical
surface. This is particularly prominent in the bilateral opercular regions
posteriorly where there are anomalous of draining veins. The operculum is the
cortex of the frontal lobe on the border with the Sylvian fissure.

The ventricular system shows dilatation of the lateral ventricles. The third
ventricle, aqueduct and fourth ventricles are normal. The first two
ventricles - the ones on the right and left sides of the brain, are bigger than
normal. The other two ventricles are normal. Also, there is increase amount
of CSF space surrounding the cerebral hemispheres. There is too large a
cerebrospinal fluid space around the outside of the brain; this is where the CSF
is taken back up. This space is called the subarachnoid space, on top of the
brain, under two of the three meninges.

There is a suggestion of some diminution in the amount of white matter;
however, this is somewhat subtle and may only be accentuated by the infolding of
the overlying dysplastic cortical mantle. The posterior fossa shows no
significant abnormalities. Posterior fossa is the back of the brain near
where it exits the skull and becomes the spinal cord.

The cervical medullary junction and pituitary fossa are normal. Back of
brain where it joins the brainstem; hole in the base of the skull where the
pituitary gland sits. The cranium demonstrates flattening in the right
parietal occipital and suboccipital region.

Also, there is suggestion of increased distance in the area of the ethmoids
between the orbits raising the question of hypertelorism. Orbits are the
bones that surround the eyeball; ethmoids are bones between the eyeball and the
bridge of the nose. Hypertelorism means the eyes are further apart than normal.

* IMPRESSION *
Cortical dysplasia most prominent in the posterior aspect of the sylvian
fissures bilaterally.

Enlargement of the supratentorial ventricular system and prominent
subarachnoid space surrounding the cerebral hemispheres. Supratentorial
refers to things above a structure near the base of the brain. In this context,
it simply means the first two ventricles, but not the 3rd and 4th. See above for
subarachnoid space.

Hope this helps a little. Typical densely written radiology report, full
of anatomical terms that there is no reason you should understand.